Schizophrenia

About schizophrenia

What is schizophrenia?

Schizophrenia is a mental illness that affects how the brain works. People with schizophrenia experience psychosis, which means they can have serious problems with thinking clearly, emotions, and knowing what is real and what is not.

This can include hearing or seeing things that are not there (hallucinations), and having very strange beliefs that are abnormal or not true (delusions).

Having psychosis often makes a person want to keep away from other people. They may have problems understanding other people’s emotions, and may feel depressed or irritable.

Other illnesses similar to schizophrenia include schizoaffective disorder and schizophreniform disorder.

While there is currently no cure for schizophrenia, it can be treated effectively with medication and psychological treatment.

Myths about schizophrenia

Myth: Schizophrenia means you have multiple personalities.Fact: A person with schizophrenia does not have multiple personalities.

Myth: People with schizophrenia aredangerous.Fact: Having schizophrenia does not mean that a person will be violent or out of control. When the illness is treated effectively, they think and act like themselves again. Someone with schizophrenia might become agitated and feel a need to defend themselves when they are frightened by hallucinations or unusual beliefs. More often, people with schizophrenia are the victims of violence from other people.

What causes schizophrenia?

The causes of schizophrenia are not yet fully understood.

Some things that make it more likely that someone will develop schizophrenia are:

having particular genes

physical injuries to the brain

traumatic experiences

using drugs such as cannabis.

Like many other illnesses, schizophrenia runs in families. People with a parent, brother or sister who has schizophrenia have a higher chance of developing schizophrenia. However, most people who have a family member with schizophrenia will not develop the illness themselves.

Symptoms of schizophrenia

Symptoms vary from person to person, and commonly include:

hearing or seeing things that are not real (hallucinations)

having very strange beliefs (delusions)

unusual thinking and speech

having problems thinking clearly

not being able to make decisions and having trouble making plans

having trouble interpreting other people’s emotions and motives

suicidal thoughts.

Some symptoms are described as ‘positive’ and others as ‘negative’.

Common ‘positive’ symptoms are hallucinations and delusions. (These are called ‘positive’ because they are extra experiences that are not part of normal experience).

Common ‘negative’ symptoms are: a loss of enjoyment of things, being unable to feel emotions, loss of interest in being with other people, and not being bothered to do anything. (These are called ‘negative’ because something is missing).

Patterns of symptoms

Times when symptoms worsen are called relapses. When symptoms improve or disappear it’s called remission.

When delusions and hallucinations occur or get worse, the person may have trouble with everyday tasks, thinking clearly, solving problems or making decisions. They may be unable to control their emotions or to get on normally with family, friends or other people, including their health-care team.

What are the first signs?

Before the signs of psychosis become obvious and schizophrenia can be diagnosed, most people have early-stage symptoms. Symptoms can include:

changes in normal behaviour, such as work or schoolwork getting worse

no longer wanting to spend time with friends

dropping out of normal activities

beginning to have unusual beliefs

hearing sounds that other people can’t hear.

Schizophrenia cannot be diagnosed this early, but it means the person is at high risk of developing schizophrenia.

The early stage is like a warning – not everyone who has these symptoms will go on to develop a psychosis such as schizophrenia. Some people with the same symptoms may go on to develop another mental illness such as bipolar disorder or anxiety or be at increased risk of self-harm.

It is important to recognise something is not right and get help. Early treatment can delay symptoms of psychosis.

Who gets schizophrenia?

Schizophrenia is seen in all countries and cultures.

Schizophrenia usually begins when people are aged between 15 and 25, but it can also start later in life. In rare cases it can start in childhood.

Schizophrenia is slightly more common in men than women. Men tend to show symptoms of schizophrenia earlier than women do.

Getting help for schizophrenia

Early medical care is vital to a good recovery. The sooner you get help, the more chance you have of getting the correct diagnosis and getting effective treatment and help to manage your problems.

Where to get help – Australia

Your GP (family doctor) – a GP can refer you to a public mental health service or a private psychiatrist, psychologist or private hospital clinic.

How is schizophrenia diagnosed?

Psychiatrists diagnose schizophrenia based on a person’s symptoms and behaviour. They will only make a diagnosis after they have spent time with the person, carefully collected information and considered other possible causes.

Getting the correct diagnosis can be difficult and take time. Having hallucinations or delusions does not mean a person definitely has schizophrenia. Other medical conditions and other mental illnesses can cause similar symptoms.

There is no test for schizophrenia and no special sign that proves someone has it.

Tests such as brain scans are sometimes needed, to make sure the symptoms are not caused by other brain problems or medical conditions.

How is schizophrenia treated?

The best treatment for schizophrenia is a combination of medication, psychological treatment and community support.

Recovery from schizophrenia

If a person with schizophrenia gets the right treatment and the support they need, they can manage their symptoms. Many people can lead full lives, even if they still have symptoms or relapses from time to time.

While there is currently no cure for schizophrenia, it can be treated effectively with medication and psychological treatment.

About 1 in 7 people with schizophrenia recover almost completely. Some people with schizophrenia only ever have one episode of psychosis and then recover well. Many have more than one episode, with good recovery or at least some recovery after each episode.

How does schizophrenia affect people?

It is not possible to predict how schizophrenia will affect someone’s life, because the symptoms, severity and pattern of illness over time differ widely between people. The impact of the illness also depends on the treatment and support they get to recover and stay well.

The risk of being unable to work or live independently is higher when schizophrenia remains untreated for a long time or when a person does not get support to continue friendships and normal activities.

Other health problems for people with schizophrenia

People with schizophrenia often have other problems with their mental health and physical health. These can include:

Suicide is one of the main causes of death for people with schizophrenia. This is mainly because they can experience severe depression, especially in the early stages of the illness. Treatment aims to overcome depression and keep the person safe.

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This is a general guide only, and does not replace individual medical advice. Please speak to your doctor for advice about your situation. The RANZCP is not liable for any consequences arising from relying on this information. Subject matter experts, people with lived experience of mental illness and carers all contributed to this fact sheet.